From 20 to 22 May, leading arrhythmologists from Russia and foreign countries gathered at the IX All-Russian Congress of Arrhythmologists in St. Petersburg. More than a thousand cardiovascular and endovascular surgeons, practicing specialists from all over the country discussed the problems and achievements in the treatment of patients with life-threatening arrhythmias.
About 300 thousand people die from these diseases in Russia every year. Several million suffer from cardiac arrhythmias.
Within the framework of the Congress, a «Mobile health care: digital technologies in arrhythmology» symposium was held. The role of digital technologies in the diagnosis, monitoring, and treatment of arrhythmias was discussed at the symposium.
The reports covered the issues of arrhythmia detection by portable devices, remote monitoring of the heart rhythm, patient-oriented digital applications to increase the effectiveness of arrhythmia therapy, and the capabilities of clinical decision support systems in this area. In the review of Russian CDSS, the Webiomed platform with extensive predictive analytics capabilities was noted.
Olga Volkova, the medical expert of Webiomed, presented the results of a study of the prevalence of atrial fibrillation (AF) and its correct diagnosis in electronic health records (EHR) contained in the Webiomed.Dataset database.
Machine learning technologies and the Webiomed.DRHA clinical decision support system were used to carry out the study. These technologies allow analyzing large arrays of medical data for the presence of atrial fibrillation and risk factors and comorbid conditions affecting this type of arrhythmia.
The main goal of the study was to identify patients with atrial fibrillation determined based on the results of ECG or Holter monitoring, however, this arrhythmia was not taken into account as a diagnosis. Thus, these patients were lost from medical sight despite having a serious illness, leading to the development of a stroke.
As a result of the analysis of 2.5 million electronic patient records, atrial fibrillation was detected in 55 thousand patients, which is 2.1% of the total sample and directly correlates with the prevalence of atrial fibrillation in the world. In 20%, the existing facts of atrial fibrillation were not taken into account as a diagnosis, and the key strategy for the prevention of complications, primarily stroke, using anticoagulant therapy was not applied to them. In the group of unaccounted for atrial fibrillation, a higher risk of stroke was identified in 3,737 (36%) - that is, these are the patients who are more likely to have a stroke and need its prevention.
Based on the results of the study, the following conclusions were made:
- The incidence of AF in EHR in 10 regions of the Russian Federation is comparable to its prevalence in the world.
- In 19%, indications of AF are present in the EHR but are not taken into account in the diagnosis.
- In the group of unaccounted for AF, the risk of thromboembolic complications is defined as high as 36.3% with an indication for anticoagulant therapy.
- CDSS can detect AF, including unaccounted for, and prompt the doctor about the presence of arrhythmia.
- The use of SPAD has the potential to improve the management of patients with AF and, given the risk of stroke, influence their prognosis.
At the moment, we are developing a special algorithm that allows us to identify suspicions, signs of "atrial fibrillation" in the absence of this diagnosis in electronic medical records. Thus, we expect to increase the detection rate of this disease, which will have a beneficial effect on the health of patients.
Event website: http://www.almazovcentre.ru/?p=70012